The CDPH Heat Risk Grid is adapted from the National Weather Service: Understanding HeatRisk.[7]

Spotlight: CDC HeatRisk Dashboard In April 2024, the CDC, in partnership with the NWS, the National Oceanic and Atmospheric Administration (NOAA), and the U.S. Environmental Protection Agency (EPA), released the HeatRisk Dashboard  -- a user- and mobile-friendly online tool for individuals (including students, parents, guardians, and more) to look up the HeatRisk for the week by entering their zip code, along with actions to keep themselves and their families safe . The HeatRisk Dashboard also includes information on heat and air quality (i.e., the Air Quality Index (AQI)  level for that day), as well as heat and health guidance for healthcare professionals (which may be useful for school-based healthcare professionals). Explore the CDC HeatRisk Dashboard >>

What is the “H​​​eatRisk” Forecast and How Do I Use It?

Screenshot of NWS HeatRisk forecast homepage and map. Source: National Weather Service.

Identifying Potential Heat Risks in a Seven-Day Forecast

Information below adapted from the NWS HeatRisk Overview.

Why Use HeatRisk?

• HeatRisk is a better indicator than using temperature alone

• HeatRisk takes into consideration how unusual the heat is for your location and time of the year

• HeatRisk accounts for how long the heat will last (including both daytime and nighttime temperatures) and for humidity

• HeatRisk incorporates data from the Centers for Disease Control and Prevention (CDC) to determine if temperatures pose an elevated risk of heat-related health impacts
  

Understanding the HeatRisk Forecast:

The National Weather Service (NWS) HeatRisk tool is a color-numeric-based index that provides a seven-day forecast of the potential level of risk for heat-related impacts to occur over each day (24-hour period). The HeatRisk tool incorporates heat-health data from the Centers for Disease Control and Prevention (CDC) to influence the local thresholds and inform the approach. That level of risk is illustrated by a color/number along with identifying the groups potentially most at risk at that level. Each HeatRisk level is also accompanied by recommendations for heat protection and can serve as a useful tool for planning for upcoming heat and its associated potential risk. Based on the NWS high resolution national gridded forecast database, a daily HeatRisk value is calculated for each location from the current date through seven days in the future. HeatRisk uses the NWS' official temperature forecast, which includes model data that takes into account urban heat islands. The National Weather Service uses this tool plus their expert judgement to declare heat advisories, watches, and warnings.

This HeatRisk tool can be used to protect lives and property from the potential risks of excessive heat, and may be especially useful for those who are more easily affected by heat or those who provide support to heat-vulnerable individuals. Weather extremes generally affect historically underserved and marginalized communities the most, and the HeatRisk forecast service ensures that communities have the right information at the right time to be better prepared for upcoming extreme heat.

The HeatRisk tool also provides additional decision-support layers (see the “layers” icon at the upper right of the map) that allow users to view geographic boundaries (including US Counties and Tribal Lands), other NWS heat information (i.e., Heat Advisory, Excessive Heat Watch or Warning), and social vulnerability (based on the CDC / ATSDR Social Vulnerability Index) as an overlay layer.

 

HeatRisk map showing Social Vulnerability Index (SVI) overlay. Accessed June 29, 2023.

What Factors Increase the Risk of Heat-Related Illness?

• Personal factors. Age, obesity, dehydration, heart disease[8], mental health conditions, poor circulation, sunburn, pregnancy, and prescription drug and alcohol use all can play a role in whether a person can cool off enough in very hot weather.

• Exertion level. Even young and healthy people can get sick from the heat if they participate in strenuous[9] physical activities such as Physical Education during hot weather without gradually acclimatizing to hot conditions over a period of 1–2 weeks.
  

• High humidity. When the humidity is high, sweat won’t evaporate as quickly. Evaporation of sweat is the main way the body can cool itself.
  
  

Who is most at risk to health effects of heat?

Extreme heat can affect anyone, but those with greater heat sensitivity or heat vulnerability are at an increased risk of heat illness and death. In many cases, there can be multiple and/or simultaneous factors affecting someone that increase their overall risk and vulnerability to heat-related health impacts. For example, someone can be unhoused (or live in a single room occupancy / SRO unit), work outdoors as an agricultural worker, have a chronic health condition, and have limited English proficiency – all factors that can contribute to the cumulative risk of heat illness and death. 

In general, populations at greater risk of heat-related health impacts include (but are not limited to) those who:

What Are Specific Actions to Protect Populations at Higher Heat Risk?

General Information and Recommendations:

• For information on protecting specific populations, including older adults aged 65+, infants and children, those with chronic conditions, low-income populations, athletes, outdoor workers, and pregnant people, please refer to the CDC’s “People at Increased Risk for Heat-Related Illness” webpage (en Español). For additional guidance (including in different languages)​ regarding protecting infants, youth, and teens, please see the California Office of Environmental Health Hazard Assessment's (OEHHA) Children and Heat webpage​.
  

• For general information on protecting people with disabilities in the face of emergencies (including heat emergencies), please refer to the resources available from Ready.Gov and the U.S. Environmental Protection Agency. 
  

• The California Governor’s Office of Emergency Services (CalOES) provides guidance on Integrated Evacuation Planning for Jurisdictions and Individuals with Access and Functional Needs (PDF).
  

• For information on protecting pregnant individuals and babies, please refer to the CDPH Safe Pregnancies in Extreme Heat webpage​. Additional resources including the OEHHA fact sheet, Pregnancy and Heat – Protect Yourself and Your Baby (PDF) and CDC’s “Clinical Guidance for Heat and Pregnancy” webpage.
  

• For information on protecting workers, please refer to the CDPH Worker HEAT (Heat Effects and Tracking) program webpage. Additional resources include a HRI signs and symptoms infographic, and data briefs on Occupational Heat Related Illness Emergency Department Visits, California, 2016-2021 (PDF) and Occupational Heat Related Illness Claims Among California Workers, 2000 - 2022 (PDF).​
  

• For additional general guidance and tips for ways to stay safe during extreme heat, please refer to the CDPH Extreme Heat homepage or the CDC Extreme Heat homepage.
  

• Provide heat-related health education or guidance information in multiple languages to ensure language accessibility. Consider translating and providing outreach in any language exceeding a certain minimum threshold or geographic concentration of individuals that speak that language. For example, the California Department of Health Care Services (DHCS) determines the non-English languages (PDF) in which, at a minimum, Medi-Cal managed care health plans must provide translated written member information (see DHSC-determined Threshold and Concentration Languages for all Counties, as of July 2021).

• The Heat Ready California awareness and outreach campaign provides heat safety materials in twelve commonly used languages in California.
  

• Listos California provides Extreme Heat resources and information in a variety of languages.
  

• The CDPH Heat & Summer Safety Communications Toolkit provides pre-developed social media and other communications materials in English and Spanish.

• Consider collaborating with other local agencies, community-based organizations, Tribes, and other stakeholders to protect community health from extreme heat to leverage resources and opportunities. For example, Public Health, Emergency Services, and other agencies at the County level can partner with city government agencies within their jurisdiction, along with Tribes, community- and faith-based organizations, and other partners to ensure coordination and collaboration regarding planning, preparedness, and response in the face of extreme heat (and other climate-related threats).
  
  

Taking Action: Considerations and Scenarios

Scenario: If air conditioning is not available in someone’s home:

• Provide information on when it may be too hot to safely stay at home (including during power outages):

• It may no longer be safe for people to stay at home when indoor air temperatures start getting into the 80s (well before 90 degrees F).[11] This is especially the case for populations at higher risk of heat-related health impacts, where it may no longer be safe at even lower indoor temperature thresholds.

• There is also increased risk of overheating in homes when high temperatures last multiple days and/or there is little to no cooling at night. 
  

• Residents on the upper floors of buildings will feel the effects of rising heat, which can elevate room temperatures and make it more difficult to maintain a consistent internal temperature if air conditioning is not available or is not used, or if ventilation is restricted.[12]
  

• Even if there is access to air-conditioning at home, people with limited or fixed incomes may not choose to use it because of concerns about energy costs (see below for additional information about programs to assist with energy bills and home energy-efficiency upgrades).
  

• When indoor air temperatures are really hot (high 90s), electric fans will not prevent heat-related illness since fans do not cool the air – they only move air around.[13]

• When indoor air temperatures get too hot to remain at home, provide guidance on transportation options to cooling centers (see below information on cooling centers and transportation).
  

• Energy Assistance and Home Energy-Efficiency Upgrade Programs Local, State, and federal programs may be available to help residents pay their energy bills, as well as to support home energy efficiency upgrades and health and safety improvements to qualifying low-income households. To learn more, please see: California Department of Community Services and Development (CSD): Assistance for Paying Energy Bills Home Energy Efficiency webpage - including information on: Low-Income Home Energy Assistance Program (LIHEAP) Weatherization Assistance Program (WAP) Low-Income Weatherization Program (LIWP) California Public Utilities Commission (CPUC):  California Alternate Rates for Energy (CARE) / Family Electric Rate Assistance Program (FERA) Local or regional utility providers (such as PG&E, SCE, or SDG&E) usually have similar programs to provide energy efficiency and weatherization services, or help pay utility bills.

  
  

• Provide information on how to stay cool at home (if people can safely do so):

• Move air to stay cool. 

• Create a cross breeze by opening doors or windows on opposite sides of the room. 
  

• REMINDER: To help ensure indoor air quality, check outdoor air quality beforehand, as hotter temperatures can coincide with higher levels of air pollution, including wildfire smoke.

• Use fans to provide air circulation. 

• Ceiling fans: setting fan to rotate counterclockwise will push air down. Check to see if your ceiling fan can do this.

• Place a box fan in a window at night.
  

• Use misting fans.

• REMINDER: While electric fans might provide some comfort, when temperatures are really hot, they will not prevent heat-related illness.

• Keep blinds and drapes closed.

• Put wet bandana or washcloth on your neck, wrists, or head. Use frozen items (e.g., ice cloths or towels, bags of frozen veggies, etc.).
  

• Self-douse with water (e.g., using spray bottle) to keep the skin wet.
  

• Take a cool shower or bath.

• Close doors in unused rooms to keep cold air where you need it.

• Turn on bathroom and stove top fans to suck hot air out.

• Use your stove and oven less to maintain a cooler temperature in your home.
  

• Stay cool during the nighttime, including to sleep better:

• Wear breathable fabrics such as cotton or linen. Avoid non-breathable synthetic clothing.

• Use breathable fabrics for bedding and sheets. 

• Avoid exercising or too much physical activity before bedtime. 

• If outdoor temperatures cool down during the evening, open windows to allow cool air in. If needed, hang a thin wet sheet or wet laundry in front of a window or fan so the air blowing inwards is cooled.
  

• Watch for signs of heat illness and seek help if needed.
  

Scenario: If someone lacks access to consistent housing or is unhoused:

For Those Who Can Travel to Another Location:

• Provide information on locations to stay cool:

• ​Cooling centers: 
  

• Check the CalOES Cooling Centers and Resources page
  

• Check with other local county or city agencies on available resources. 

• Search for Cooling and/or Community Centers (i.e., use Google Maps or other tools -- search “community / cooling centers near me”).
  

• Search for Clean Air Centers / Shelters.

• Search for city or other government buildings that can provide relief.

• California Public Utilities Commission (CPUC) Cooling Centers webpage (including links to cooling centers in utility territories). 
  

• CONSIDERATIONS:
  

• Confirm availability of drinking water at cooling / respite centers, and encourage hydration
  

• Ensure that people with disabilities and individuals with access and functional needs can be served equitably at cooling centers. See the CalOES Accessible Cooling Centers Guide (PDF).
  

• Ensure that pets are also allowed at the cooling centers (indoors - not just kenneled outside), while also being sensitive to the needs of those with allergies to pet dander. Consider having a separate area for pets.

• For additional guidance for local health jurisdictions to support a safe, clean environment for visitors and staff at cooling centers, please view the CDPH Cooling Centers Guidance
  

• Other public places with air conditioning: 

• Public libraries: 
  

• California State Library - “Find Your Local Library” mapping tool
  

• Shopping malls and other commercial facilities open to public
  

• Public parks, fairgrounds, and other public areas with shade or other cooling measures:

• Search for local public parks and other shaded public spaces (i.e., use Google Maps or other tools -- search “parks with shade near me”).

• Search for public pools or water access.

• Search for local / regional fairgrounds that have been activated as cooling centers.

• California Department of Food and Agriculture (CDFA) – List of State-Designated Fairs
  

• Search for regional and/or state parks

• California State Parks mapping tool
  

• Search for online mapping tools that show where shade will occur throughout the day (e.g., Shademap, Shadowmap -- please note, these specific tools have not been thoroughly vetted by CDPH, and CDPH does not necessarily endorse using these tools -- they are included here as examples).
  

• Call 2-1-1 to find essential community services

• Call to find locations and resources for staying safe during extreme heat (e.g., call to find local cooling center; for San Diego County, seniors, people with disabilities or those on limited incomes can request a free electric fan from the county at no cost by calling 211*).

• REMINDER: While electric fans might provide some comfort, when temperatures are really hot, they won’t prevent heat-related illness.

• 211 can provide information in different languages.

• Call to request transportation services information (see more below).
  

• Provide transportation information and services for accessing cooling centers and other places to stay cool

• Call 5-1-1 to find real-time traveler information or visit the 511 Real Time Traveler Information site
  

• Search online for specific 511 information for your location. Some regional 511 links are provided below:
  

• Bay Area 511 
  

• Sacramento Region 511
  

• San Diego Region 511
  

• Santa Cruz 511
  

• Southern California 511 
  

• Check with local / regional transit agencies for public transit access, including free or discounted rides during extreme heat.

• American Public Transit Association (APTA): Look up California transit agencies and other information
  

• Transit Link: California Public Transportation Maps
  

• CONSIDERATION: Public transit can even provide temporary cooling and relief within the air-conditioned vehicles.
  

For Those Who Cannot Easily Travel to Another Location: 

• Encourage and facilitate buddy systems or other arrangements ​​for regularly checking in on heat-vulnerable individuals by family, friends, neighbors, and/or colleagues during hot weather.
  

• Activate and deploy home visiting and other programs to check on people and provide relief where they are

• This can include In-Home Supportive Services (IHSS) workers, asthma home visitors, Black Infant Health home visitors, community health workers / promotores, Meals on Wheels, nurse home visitors, CalWORKs Home Visiting Program, or any other local health and human services or programs (including Child, Family, and Adult Services).
  

• Partner with local / regional community-based organizations, faith-based organizations, mutual-aid networks, Voluntary Organizations Active in Disaster (VOAD), Community Emergency Response Teams, and other community service organizations to check on priority populations and provide services and assistance.

• Provide water, fans, portable shade and other protective measures (e.g., hats, umbrellas, fabric shade coverings, clothes that are looser / more breathable, etc.), food and medication (especially if power is out).
  

• Provide support to unhoused residents: 

  • Provide direct resources, including water, shade structures, ice, and other basic needs. 
    

  • Provide suggestions for unhoused people and those living in tents on strategies to stay safe and cool, for example, simple instructions on how to string up tarps or other coverings in such a way that provides shade and ventilation while reducing heat build-up.
    
    

Scenario: If someone is taking medication:

For people taking psychotropic medications:

• Provide information based on the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Tips for People Who Take Medication: Coping with Hot Weather (PDF)

• People taking certain psychotropic medications (antidepressants, anti-anxiety medications, stimulants, antipsychotics, and mood stabilizers) may be at greater risk of heat illness when temperatures increase. This is because some psychotropic medications interfere with a person’s ability to regulate heat and their awareness that their body temperature is rising.[14] 

For older adults taking medications:

• Provide information based on the CDC’s Heat and Older Adults (Aged 65+) webpage

• Older adults may not be able to adjust to sudden temperature changes quickly because of certain medications they take or chronic illnesses that affect their ability to regulate body temperature.[15]
  

• Commonly used medications by older adults that can increase the risk of heat-related illnesses include (but are not limited to) diuretics, beta blockers, antidepressants, antipsychotics, and anticholinergics. Along with potentially affecting thermoregulation, these medications can lead to dehydration, electrolyte imbalance, reduced sweating, decreased sensation of thirst, cognitive impairment, and other effects that increase risk of heat-related illness.[16]
  

Scenario: If someone has or cares for a pet or other animal:

• Provide information on how to protect pets during hot weather by referring to the CDPH Protecting Your Pet During Hot Weather webpage

• Never leave pets in a parked vehicle. Even cracked windows won’t protect your pet from suffering from heat stroke, or worse, during hot summer days.
  

• Pets and companion animals feel the heat just as much as humans do and they can also suffer from heat-related illnesses. Heat stroke in pets is a life-threatening emergency and can lead to organ damage or death if not treated quickly. Know the symptoms of overheating for animals, including excessive panting or difficulty breathing, increased heart and respiratory rate, drooling, mild weakness or lethargy, stupor or even collapse, excessive thirst, and vomiting or diarrhea.
  

• Help establish or provide information on pet-friendly cooling centers

  • It is important to work with your local cooling centers to allow pets and other companion animals inside (while reserving safe space for people with animal allergies), since many people may not want to or are not able to leave their pets behind.
    

For those with livestock and/or other farm animals:

• Provide information on protecting livestock or other farm animals by referring to the following resources:

• California Department of Food and Agriculture (CDFA):

• For general information about animal health for livestock and farm animals, please visit the CDFA Division of Animal Health and Food Safety Services (AHFSS) webpage
  

• Center for Food Security and Public Health – Iowa State University:

• Excessive Heat and Your Livestock (PDF)
  
  

What Other Heat Guidance is Available?

Protecting Students Engaging in Sports and Strenuous Activities:

CDPH Health Guidance for Schools on Sports and Strenuous Activities During Extreme Heat
The CDPH health guidance for schools provides additional or supplemental information and guidance – it does not replace local plans. If a school or local jurisdiction has an existing heat emergency or emergency action plan, consult with the existing plan first. For California Interscholastic Federation (CIF) member schools, additional sports heat requirements may apply.​

Key Take-Aways for School / Athletics Administrators:

• Know your location’s “HeatRisk” level to determine when to cancel activities or move to alternative activities in cooled indoor spaces. If a circumstance is unclear or uncertain, cancel.
  

• Be aware that multiple days of extreme high temperatures will make students and athletes more vulnerable to heat illness.

• Always monitor for exertional heat illness. Air temperature, humidity, direct sunlight, and other factors can increase risk of heat illness.

• Be aware that exertional heat stroke is life-threatening. Exertional heat stroke can occur within the first 60 minutes of exertion and may be triggered without exposure to high ambient temperatures.

• Proceed with extra caution in scenarios where extreme heat occurs suddenly, lasts an extended period of time, and/or reaches new high temperatures. Generally, in these scenarios, very few outdoor activity participants (or those participating in indoor spaces without cooling) are “acclimatized.”
  

Protecting Workers from Extreme Heat:

Cal/OSHA ​Indoor Heat Illness Prevention​

• Cal/OSHA's Heat Illness Prevention in Indoor Places of Employment regulation (PDF) applies to most indoor workplaces, such as restaurants, warehouses, and manufacturing facilities where temperatures can get high. ​

• For indoor workplaces where the temperature reaches 82 degrees Fahrenheit, employers must take steps to protect workers from heat illness. Some of the requirements include providing water, rest, cool-down areas, methods for cooling down the work areas under certain conditions, and training.

• Employers may be covered under both the indoor and outdoor regulations if they have both indoor and outdoor workplaces. ​​
  

Cal/OSHA Heat Illness Prevention for Outdoor Workers (en​ Español)

• California employers are required (per Cal/OSHA Heat Ill​ness Prevention Standard​) to take the following steps to protect outdoor workers from heat illness:

• Plan: Develop and implement an effective written heat illness prevention plan that includes emergency response procedures.​

• Training: Train all employees and supervisors about heat illness prevention. 

• Water: Provide drinking water that is fresh, pure, suitably cool, and free of charge so that each worker can drink at least 32 ounces (or four cups of water) per hour and encourage workers to do so.

• ​Rest: Encourage workers to take a cool-down rest in the shade for at least five minutes when they feel the need to do so to protect themselves from overheating. Workers should not wait until they feel sick to cool down.​

• ​Shade: Provide proper shade when temperatures exceed 80 degrees. Workers have the right to request and be provided shade to cool off at any time.​
  

   

​​
​Cal/OSHA’s Heat Illness Prevention special emphasis program includes enforcement of the heat regulation as well as multilingual outreach and training programs for California’s employers and workers. Details on heat illness prevention requirements and training materials are available online on Cal/OSHA’s Heat Illness Prevention webpage and the 99calor.org (​en Español) informational website. A He​at Illness Prevention ​online tool​ is also available on Cal/OSHA’s website.​

Guidance on “acclimatization,” or the “temporary adaptation of the body to work in the heat that occurs gradually when a person is exposed to it. Acclimatization peaks in most people within four to fourteen days of regular work for at least two hours per day in the heat.” Visit the Cal/OSHA eTool’s Acclimatization page.

CDC / National Institute of Occupational Safety and Health (NIOSH) - Heat Stress

• Additional guidance and resources can be found on the CDC / NIOSH Heat Stress webpage​, including guidance for ​Limiting Heat Burden While Wearing Personal Protective​ Equipment (PPE)​.​
  

Health Care Facilities

CDPH All Facilities Letter (AFL 24-13) - Hot Summer Weather Advisory

• This AFL reminds health care facilities to implement recommended precautionary measures to keep individuals safe and comfortable during extremely hot weather.

• Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications.

• Facilities must report extreme heat conditions that compromise patient health and safety and/or require an evacuation, transfer, or discharge of patients. 
  
  

Child Care Licensees and Providers

California Department of Social Services (CDSS) - Provider Information Notice (PIN): Extreme Heat Hazard Awareness Focusing On Infants and Young Children (PDF)

• Licensees and Providers must take precautions to ensure the health and safety of children when experiencing extreme weather conditions, such as high heat. 

• This PIN provides information about high heat hazards specific to child care providers caring for young children. 

• Per Title 22, Section 101239 for child care centers, the licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F and a maximum of 85 degrees F.
  
  

Cooling Centers Guidance for Local Health Departments

CDPH Local Health Department Cooling Centers Guidance

Cooling centers (a cool site or air-conditioned facility designed to provide relief and protection from heat) are used by many communities to protect health and mitigate heat impacts during heat events, especially for high-risk populations that are disproportionally affected by extreme heat. This document provides general guidance for Local Health Jurisdictions to support a safe, clean environment for visitors and staff at cooling centers.

• Cal OES Accessible Cooling Centers Guide (PDF) - Guide to support jurisdictions in planning for, and operating, accessible Cooling Centers that can serve people with disabilities and individuals with access and functional needs in an inclusive and equitable manner. 
  
  

Health Equity Guidance for Local Health Departments

Interim Guide to Health Equity-Centered Local Heat Planning

This guide is intended as a planning resource for local jurisdictions to help with protecting the entire community from extreme heat regardless of residents’ background and access to resources, and in particular those with the least opportunity for good health. This guide is intended to assist local jurisdictions with incorporating health equity into new or existing heat planning efforts. Strategies or elements from this document can comprise a new or updated stand-alone heat plan, or be incorporated into Local Hazard Mitigation Plan updates, Climate Action & Adaptation Plans, General Plan Safety Elements, or Public Health Emergency Preparedness Plans.  This resource can help facilitate partnerships between local health departments, offices of emergency services, and other local agencies.

Addressing Air Quality Impacts During Extreme Heat

• Higher temperatures can lead to an increase in ozone, a harmful air pollutant.[17] Visit the AirNow website to check the Air Quality Index (AQI) in your area to determine if air quality is healthy or unhealthy, and to access resources for protecting community health from poor air quality .
  

• Hotter temperatures and drought conditions can increase the risk of wildfires. Wildfire smoke can severely impact air quality locally and downwind. Heath effects from exposure to particulate matter in wildfire smoke can include eye and lung irritation, exacerbation of asthma, and other impacts.[18] Learn more about addressing the health effects of wildfire smoke here: CDPH Wildfire Smoke - Considerations for California’s Public Health Officials (PDF).
  
  

Communicating Heat Risk

UCLA - Communicating Heat Risk: A Guide to Inclusive, Effective, and Coordinated Public Information Campaigns (PDF)

This report collects insights and guidance for communicators in an accessible, practical format that can strengthen communication efforts. It presents  recommendations in five areas to support heat communicators to create more inclusive, effective, and coordinated public information campaigns.​

Extreme Temperature Response Plan

CalOES - Extreme Temperature Response Plan (PDF; Annex to the State Emergency Plan)

The plan describes state operations during an extreme temperature warning and provides guidance for state agencies, local governments, tribes, and non-governmental organizations (NGOs) in preparation for their heat and cold/freeze response plans and other related activities. The plan establishes best practices for local governments through guidance and checklists and recognizes that some local agencies may already have a system for managing extreme temperatures. The plan utilizes the National Weather Service (NWS) forecast product HeatRisk, which provides daily guidance on potential heat risks.

Are There Examples of Local Heat Response Measures?

Local Health Jurisdiction Response Examples from the 2022 September Statewide Heat Emergency

Madera County:

• Sending out information through multiple communication channels such as:
  

• Madera County site  
  

• Social media

• Exploring other direct push messaging through OES text system and school district parent messaging (which has become a really strong messaging platform – parents in jurisdictions got used to looking at it all the time during COVID)
  

• Through the Sheriff’s Program site 
  

• “Elder Orphans is a telephonic messaging service which stores subscriber’s name, telephone number, address, emergency contact information, and call times. The program was created by the Madera County Sheriff’s Office to meet the needs of Madera County’s Senior Citizens who live alone. Elder Orphans is a free house check calling program for people who want daily contact by receiving a pre-recorded message on their home phone. You select when you want us to call you and how often.”

Trinity County:

• Local protocol: Maintain open lines of communication with our utility providers to know whether they expect disruption to their systems. In this case, local utility, PG&E, is very good at communicating with their customers directly if there are any concerns. Trinity County distributes messaging via social media about staying cool and limiting outdoor activity during excessive heat. Due to the fires, Trinity County also has ‘clean air centers’ that can double as a cooling center for the public and these are also advertised to the community.
  

Yuba / Sutter Counties:

• Ensure that pets are allowed at the cooling centers (indoors - not just kenneled outside) 

• Transportation is very important so ensure that local transit is open (especially during holidays and weekends)

• Outreach to Access and Functional Needs clients and IHSS clients is important to ensure they have all the information and assistance that they need

• Consider having specific cooling options for unhoused clients separate from general population

San Francisco City / County:

• Developed internal Extreme Heat public health response guidance document for the Department

• Provides information on extreme heat emergencies, heat-related health conditions, vulnerable populations, temperature thresholds, activation and notification phases, potential city-wide impacts, lead response and partner agencies, and more.

• Key Consideration for Vulnerable Populations: Guidance for San Francisco population (and other populations and geographic locations) that have historically not experienced extreme heat events for extended durations:
  

• “the population – in particular…vulnerable groups… -- has greater difficulty acclimating to long durations of extremely high temperatures. This causes an increased risk of heat stress and of heat related illness, which could subsequently result in death. Furthermore, the housing stock in San Francisco is also less likely to have central air conditioning both because of its age and because of the typically cooler climate.”

Los Angeles County

• Ready LA County - Extreme Heat site published

• Comprehensive / centralized website for providing locations of cooling centers, guidance on staying safe during extreme heat, and more.
  

What Other Heat Planning and Response Tools Are Available?

Climate Change and Health Vulnerability Indicators (CCHVIs) for California

Identifying and Prioritizing Communities with Greater Climate Change and Health Vulnerability

Utilize the CDPH Climate Change and Health Vulnerability Indicators (CCHVIs) for California and data visualization platform (CCHVIz) to help define the scope of climate impacts and identify the populations and locations that are most vulnerable to those impacts, including for extreme heat.

The indicators are grouped into three types: 

1. Environmental or Climate Exposure Indicators, including for heat, air quality, drought, wildfires, and sea level rise. 

2. Indicators that speak to a community’s capacity to adapt to climate exposures, including things like air conditioning ownership, tree canopy, impervious surfaces, and public transit access. 

3. And lastly, indicators that account for populations with greater sensitivity to climate exposures – including children and elderly, those living in poverty, and data on race and ethnicity, linguistic isolation, disability, and more. 
   

The data can be downloaded from the CDPH website, along with a description of why each indicator is relevant to climate change and health equity. 

California Heat Assessment Tool (CHAT)

Exploring and Understanding How Extreme Heat Will Impact Specific Communities Across California Using Heat Health Data

The California Heat Assessment Tool (CHAT) allows users to better understand the determinants of heat-related health impacts in your community and prioritize protecting those who are most vulnerable. You can use CHAT to explore how Heat Health Events (HHEs) are projected to change in your area at the census tract level (a Heat Health Event is any heat event that generates public health impacts, regardless of the absolute temperature). CHAT was built for planners, policymakers, public health practitioners and community members who are committed to mitigating the public health impacts of heat in their communities.

California Healthy Places Index (HPI): Extreme Heat Edition 

Understanding Underlying Heat Vulnerability and Resilience Characteristics of a Community

The California Healthy Places Index (HPI): Extreme Heat Edition is a tool developed by the Public Health Alliance in partnership with the UCLA Luskin Center for Innovation. The tool provides datasets on projected heat exposure for California, place-based indicators measuring community conditions and sensitive populations. It also provides a list of resources and funding opportunities that can be used to address extreme heat.

The tool can be used to:

• Understand underlying heat vulnerability and resilience characteristics of a community

• Identify resources to mitigate adverse effects of extreme heat

• Prioritize public and private investments, resources and programs
  

UCLA Heat Maps

Find out which communities are at greatest risk of harm during extreme heat days

Developed by the University of California at Los Angeles (UCLA) Center for Healthy Climate Solutions and the UCLA Center for Public Health and Disasters, the UCLA Heat Maps is an interactive mapping tool for displaying heat-related health outcomes in California, showing the excess daily emergency room visits that occur on an extreme heat day compared to the usual, non-extreme heat day. It shows this excess by county and zip code. By using the map, public health professionals, emergency service providers, urban planners, legislators, health and human services providers, non-governmental organizations, and communities themselves can find out which neighborhoods across the state are at greatest risk of harm during extreme heat events.

Heat Safety Tool App (OSHA-NIOSH)

Planning Outdoor Work Activities Based on How Hot It Feels

The OSHA-NIOSH Heat Safety Tool is a useful resource for planning outdoor work activities based on how hot it feels throughout the day. It has a real-time heat index and hourly forecasts specific to your location. It also provides occupational safety and health recommendations from the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH).

The OSHA-NIOSH Heat Safety Tool features:

• A visual indicator of the current heat index and associated risk levels specific to your current geographical location
  

• Precautionary recommendations specific to heat index-associated risk levels

• An interactive, hourly forecast of heat index values, risk levels, and recommendations for planning outdoor work activities
  

• Location, temperature, and humidity controls, which you can edit to calculate for different conditions

• Signs and symptoms and first aid for heat-related illnesses
  

Download on the Apple App Store

Download via Google Play 

Key considerations for using the app (from CDC Heat Safety Tool webpage):

• Heat index (HI) values were created for shady, light wind conditions, so exposure to full sunshine can increase heat index values by up to 15°F.

• The simplicity of the HI makes it a good option for many outdoor work environments (if no additional radiant heat sources are present, such as, fires or hot machinery). However, if you have the ability, NIOSH recommends using wet bulb globe temperature (WBGT)-based Recommended Exposure Limits (RELs) and Recommended Alert Limits (RALs) in hot environments.

• Use of the HI or WBGT is important, but other factors such as strenuous physical activity also cause heat stress among workers. Employers should have a robust heat stress prevention program that ensures workers are protected.

• NIOSH and OSHA are considering new scientific data related to the HI levels, and considering how to best incorporate the evolving science. It is important to regularly download updates to ensure you are using the latest version of the app.